There are many occasions where a temporary ileostomy would be desirable to drain effluent from the small intestine for a temporary period of time, to enable analysis, repair and/or healing at a downstream site in the large intestine. Typically, a temporary ileostomy involves two surgical operations, namely (i) a colon resection during which the abdominal wall and intestinal wall are opened to create the temporary ileostomy diversion, and (ii) a later closure operation (laparotomy) which closes the openings in the intestinal wall and the abdominal wall to restore the normal intestinal route for effluent. The second operation normally occurs around 4 to 6 months after the first. However, the combination of two serious surgeries has a high morbidity and mortality problem, and the costs of two such serious operations are very high. The risks and costs mean that a temporary ileostomy is not used as extensively as it might be in all cases. Also, the risks of the second serious operation may be too high for many patients resulting in the temporary becoming a permanent ostomy.
EP-A-1779823 describes a transcecal ileostomy set intended to addresses these problems. Only the single initial surgical operation is needed. The catheter is inserted during the surgery to treat the large intestine. The catheter enters the body through an incision through the abdominal wall and then the intestine via an incision made in the large intestine wall, and extends through the cecal valve into the small intestine. A feature of EP-A-1779823 is that catheter is not directly fastened or sealed to the intestine, e.g., by sutures or surgical staples that would require a second surgical operation to remove. Instead, the catheter has two inflatable balloons, one of either side of the cecal valve. A blocking balloon on the small intestine side obstructs the small intestine, and causes effluent to be diverted into the catheter. A fixation balloon on the large intestine side fixes the catheter with respect to the large intestine. There is no disclosure of the balloon construction, which presumably is conventional using thin elastic material that stretches as the balloon expands. A bioresorbable loop passes around the opening in the large intestine wall, and is fastened to a plastic holder outside the patient's abdominal wall. The holder includes a rotary part for tightening the loop, in order to purse the opening in the large intestine wall around the catheter, and to draw the large intestine wall against the abdominal wall. To remove the catheter, the balloons are deflated, allowing the catheter to be withdrawn without surgery. The bioresorbable loop is then further tightened to purse the incision in the large intestine wall closed.
It would be desirable to further refine a temporary ostomy appliance to improve its characteristics.